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TEPES 2008 Beach CME Conference Registration
Using the Mail
TEPES has applied for 15 hours of Cat I CME and 18 NCNA contact hours.
Fee includes all meals and activities. (Note there is a guest fee for the Friday
Night Beach Bash-new event this year.)
Cancellations will be honored if received by May 29, 2008($35 administrative
fee deducted for all cancellations)
Only registered participants allowed to attend the educational sessions.
TEPES reserves the right to make scheduling changes without prior notification.
Space is limited to 100 attendees.
You may print this page and use it to register for the 2008 TEPES Beach CME Conference
Name:____________________________________________________________________________
Credentials (i.e., PA-C, NP, etc):_________________
Home
Address:_____________________________________________________________________
City:__________________________________________ State:_______ Zip:___________________
Home phone:_____________ Work phone:______________
E-mail:_________________________
Work
Address:______________________________________________________________________
Please check ONE of the following:
Early Bird Fees Regular Fees
TEPES Member $135 (postmarked by March 31, 2008): ____
TEPES Member $175 ____
Non-Members $175 (postmarked by March 31, 2008): ____
Non-Members $200 ____
If you and/or guest(s) will be attending the Friday Night Beach Bash, complete the
following:
Friday Night Beach Bash
I will attend (price included in registration) ___
I will not be attending the Shrimp-A-Roo ___
Adult Guests ____($35 for each ) Children (4-12 years)
____ ($12.50 for each) = Total: $_________
Grand Total Enclosed................................
$_________________________________
registration + fee for guest(s) at Friday Night Beach Bash
Make checks payable to TEPES
Mail completed forms to:
TEPES